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Frequency of Sperm Cells with Fragmented DNA in Males Infected with Chlamydia
Trachomatis and Mycoplasma SP,
Determined with the Sperm Chromatin Dispersion
(SCD) Test.
J. L. Fernandez, B. Ramos, R. Santiso,
A. Agarwal, J. Gosalvez, G. Gallegos
Seccion de Genetica y Unidad de
Investigacion, Complejo Hospitalario Universitario Juan Canalejo, A Coru~na,
Spain; Laboratorio de Genetica Molecular y Radiobiologia, Centro Oncologico de
Galicia, A Coru~na, Spain;
Facultad de Medicina, Universidad de Nuevo Leon, Monterrey, Mexico; Glickman
Urological Institute and Department of Obstetrics and Gynecology,
The Cleveland Clinic Foundation, Cleveland, OH; Unidad de Genetica, Facultad de
Biologia, UniversidadAutonoma de Madrid, Madrid, Spain.
Monday, October 15, 2007
Objective:
To determine the frequency of sperm cells with fragmented DNA in
semen samples from men with genitourinary infection by Chlamydia trachomatis and
Mycoplasma sp., and the influence of antibiotic therapy.
DESIGN: Prospective study in 143 males from couples attending the andrology-
infertility center and a control group of 50 fertile subjects. The effect
of antibiotic treatment was assessed in 95 male patients.
Materials and Methods:
Standard semen analysis, sperm DNA
fragmentation and clinical outcome were estimated. Sperm DNA fragmentation
was determined using the SCD test (Ferna´ndez et al., Fertil Steril
84:833–42, 2005).
Results:
The percentage of sperm cells with fragmented DNA was
35.2 13.5, 3.2 times higher than the control fertile group (10.8 5.6).
Concentration,
morphology and motility were also significantly affected but in
a much lower magnitude: 1.7 times, 1.8 times, and 1.1 times average lower
than control, respectively. After 3.8 2.2 months of antibiotic treatment,
the frequency of sperm cells with fragmented DNA decreased from 37.7 13.6 to
24.2 11.2 (Wilcoxon test, P<0.0001). The relative percentage of
improvement was greater for DNA integrity (median: 35.7%) than it was
for morphology (median: 25.0%). Sperm concentration and motility were
not significantly improved. Remarkably, while only 12.5% of couples
achieved pregnancy during antibiotic treatment course (n ¼ 16), 85.7% of
couples achieved pregnancy after antibiotic treatment (n ¼ 14) (Spearman
r correlation coefficient: 0.73, P<0.0001; c2 test, P<0.0001). The only
significant
differences found between both groups was the rate of sperm DNA
fragmentation (P¼0.047) and morphology (P¼0.040).
Conclusions:
Patients with genitourinary infection by Chlamydia trachomatis
and Mycoplasma sp. have increased frequency of sperm DNA fragmentation
in comparison to fertile controls. This increase is proportionally
greater than that found in classical semen parameters. After antibiotic therapy,
DNA fragmentation is decreased to a greater extent than for any other
semen parameter. These results suggest that genitourinary infection by Chlamydia
trachomatis and Mycoplasma sp. may result in a decreased fertility potential
due to sperm DNA fragmentation. Antibiotic therapy appears to be
important in providing remedy for infection-induced high DNA fragmentation
levels.
Supported by: Xunta de Galicia, grant PGIDIT 04BTF916023PR.
